Salmonella Gastroenteritis (Baby/Toddler)

Home care

Follow all directions given by your child’s doctor.

If giving medicines to your child:

• Don’t give over-the-counter diarrhea medicines unless your child’s doctor tells you to. They can make the illness last longer.

• If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.

• You can use acetaminophen or ibuprofen to control pain and fever. Or other medicine as prescribed.

• Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.

To prevent the spread of illness:

• Remember that washing with soap and water and using alcohol-based sanitizer is the best way to prevent the spread of infection.

• Wash your hands before and after caring for your sick child. When cleaning up vomit or diarrhea, instead of using an alcohol-based sanitizer, it's best to wash and scrub your hands with soap and clean, running water for at least 20 seconds.

• Clean the toilet or the diaper change area after each use. Dispose of soiled diapers in a sealed container.

• Keep your child out of day care until your child's doctor says it's OK.

• Teach your child to wash their hands after using the toilet and before meals. This is very important if your child is in day care.

• Make sure your child stays away from contact with the feces of reptiles (turtles, lizards, and iguanas), birds, dogs, and cats. Wash hands with soap after handling reptiles, birds, or baby chicks, and after contact with pet feces.

• Wash your hands before and after preparing food. Keep in mind that people with diarrhea or vomiting should not prepare food for others.

• Wash your hands after using cutting boards, counter tops, and knives that have been in contact with raw foods.

• Wash and then peel fruits and vegetables.

• Keep uncooked meats away from cooked and ready-to-eat foods.

• Wash all cooking utensils (including cutting boards) after they touch raw food.

• Use a food thermometer when cooking. Cook poultry to at least 165°F (74°C). Cook ground meat (beef, veal, pork, lamb) to at least 160°F (71°C). Cook fresh beef, veal, lamb, and pork to at least 145°F (63°C).

• Don’t serve raw or undercooked eggs (poached or sunny side up), poultry, meat, or unpasteurized milk and juices to your child.

• Don't eat foods prepared with unpasteurized milk.

Giving liquids and feeding

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving small amounts of liquids often.

If your baby is breastfed, continue breastfeeding. Breastmilk usually contains all the fluids and electrolytes they need. 

If your baby is breastfed:

• For diarrhea.  Breastfeed your child more often than usual. If diarrhea is severe, give oral rehydration solution (ORS) between feedings. As diarrhea decreases, stop giving ORS and resume your normal breastfeeding schedule.

• For vomiting. After 2 hours with no vomiting, restart breastfeeding. Spend half the usual feeding time on each breast every 1 to 2 hours. If your child vomits again, reduce feeding time to 5 minutes on 1 breast only, every 30 to 60 minutes. Switch to the other breast with each feeding. Some milk will be absorbed even when your child vomits. As vomiting stops, resume your regular breastfeeding schedule.

If your baby is bottle-fed:

• Give small, frequent amounts of fluid at a time, especially if your child is vomiting. An ounce or 2 (30 to 60 mL) every 30 minutes may improve symptoms. Start with 1 teaspoon (5 mL) every 5 minutes and increase gradually as tolerated.

• For diarrhea. Give full-strength formula or milk. If diarrhea is severe, give ORS between feedings. If giving milk and the diarrhea is not getting better, stop giving milk. In some cases, milk can make diarrhea worse. Try soy or rice formula. Don't give apple juice, soda, or other sweetened drinks. Drinks with sugar can make diarrhea worse. If your child starts doing worse with food, go back to clear liquids.

• For vomiting. After 2 hours with no vomiting, try giving regular formula or milk. If at any time the child starts to vomit again, go back to small amounts of clear liquids. Start with small amounts and increase the amount as tolerated.

• If your child is doing well after 24 hours, resume a regular diet and feeding schedule.

If your child is on solid food:

• Keep in mind that liquids are more important than food right now. Give small amounts of liquids at a time, especially if your child is having stomach cramps or vomiting.

• For diarrhea. If you are giving milk to your child and the diarrhea is not going away, stop the milk. Most children can tolerate milk even though they have diarrhea. However, in some cases, milk can make diarrhea worse. If that happens, use ORS instead. If diarrhea is severe, give ORS between feedings.

• For vomiting. Begin with ORS at room temperature. Give 1 teaspoon (5 ml) every 5 minutes. Even if your child vomits, continue to give ORS. Much of the liquid will be absorbed, despite the vomiting. After 2 hours with no vomiting, start with small amounts of milk or formula and other fluids. Increase the amount as tolerated. As vomiting decreases, try giving larger amounts of ORS. Space this out with more time in between. Continue this until your child is making urine and is no longer thirsty (has no interest in drinking). After 4 hours with no vomiting, restart solid foods. After 24 hours with no vomiting, resume a normal diet. Ask your doctor if you can give your child plain water, milk, formula, or other liquids before the vomiting stops.

• You can resume your child's normal diet over time as they feel better. Don’t force your child to eat, especially if they are having stomach pain or cramping. Don’t feed your child large amounts at a time, even if they are hungry. This can make your child feel worse. You can give your child more food over time if they can tolerate it. For a baby over 4 months, you can give cereal, mashed potatoes, applesauce, mashed bananas, or strained carrots during this time. For children age 1 or older, you can add crackers, white bread, rice, crackers, and other complex starches, lean meats, yogurt, fruits, and vegetables. Low fat diets are easier to digest than high fat diets.

• If the symptoms come back, go back to a simple diet or clear liquids.

Follow-up care

Follow up with your child’s doctor, or as advised. If a stool sample was taken or cultures were done, call the doctor for the results as directed.

Call 911

Call 911 if:

• Your child has trouble breathing or their skin or lips look blue purple, or gray

• Your child appears confused or doesn't respond well.

• Your child is extremely drowsy or has trouble walking.

• Your child loses consciousness.

• Your child has a fast heart rate.

• Your child has a stiff neck.

• Your child has a seizure or rhythmic jerking of arms and legs.

When to contact your child's doctor

Contact your child’s doctor right away if:

• Your child has belly (abdominal) pain that gets worse.

• Your child has constant lower right belly pain.

• Your child has repeated vomiting after the first 2 hours on liquids.

• Your child has occasional vomiting for more than 24 hours.

• Your child has more than 8 diarrhea stools in 8 hours.

• Your child has severe diarrhea for more than 24 hours.

• Your child can't eat or drink.

• There's blood in your child's vomit, stool, or urine.

• Your child won't drink or feed.

• Your child has dark urine or no urine for 6 hours, no tears when crying, sunken eyes, or a dry mouth.

• Your child has fussiness or crying that can't be soothed.

• Your child is abnormally drowsy.

• Your child has a new rash.

• Your child's diarrhea lasts more than 1 week.

• Your child has a fever (see "Fever in children" below).

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to call a doctor about your child’s fever

For a baby under 3 months old:

• First, ask your child’s doctor how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the doctor